Helping runners to avoid physical problems - Feet - The American College of Foot and Ankle Surgeons - Brief Article

Long-distance runners and casual joggers can improve their performance by keeping their feet in top condition and taking steps to control foot problems common in runners, according to the American College of Foot and Ankle Surgeons (ACFAS). "The human foot is a biological masterpiece that amazingly endures the stresses of daily activity," says Marybeth Crane, a spokesperson for the ACFAS and a foot and ankle surgeon in the Dallas/Fort Worth, Tex., area. "For runners, the feet are more vulnerable to injury than any other part of the body, and these athletes should be on the alert for signs of foot problems that can slow them down if not treated promptly."

An avid marathon runner, Crane says the most common complaint from runners is heel pain caused by inflammation of the ligament that holds up the arch, a condition which is known as plantar fasciitis. "In athletes, heel pain can result from faulty mechanics and overpronation in which pressure is unequally applied to the inside of the foot. It also can be caused by wearing running shoes that are worn out or too soft." At the first sign of heel pain, she advises runners to do stretching exercises, wear sturdier shoes, and use arch supports. In some cases, icing and anti-inflammatory drugs, such as ibuprofen, are helpful. Should heel pain continue, custom orthotics, injections, and physical therapy might be required. Surgery normally isn't considered unless heel pain persists for more than a year and conservative treatment has failed to bring relief.

Neuromas and tendonitis are other common foot ailments that affect runners. A neuroma is a pinched nerve between the toes that can cause pain, numbness, and a burning sensation in the ball of the foot. Overly flexible shoes often are the cause, and padding, orthotics, or injections usually are effective. Sometimes, surgery is the answer if pain between the toes continues for a period exceeding six months.

Serious runners can be sidelined with tendonitis if they ignore the warning signs of this overuse-related condition. "There are several forms of tendonitis that affect the Achilles and other areas, and all are treated with rest, icing, stretching, and anti-inflammatory medications, and sometimes with orthotics and physical therapy," Crane notes. "Overzealous training usually causes tendonitis, especially among beginners who try to do too much too soon."

A common myth among athletes is that it is not possible to walk or run if a bone in the foot is fractured. "I often hear surprised patients say `It can't be broken; I can walk on it.' That's dead wrong, especially with stress fractures when pain and swelling might not occur for a few days." If a fracture or sprain is suspected, she advises runners to remember the word RICE as an abbreviation for Rest-Ice-Compression-Elevation. "Should pain and swelling continue after following this procedure for three or four days, you should see a podiatric foot and ankle surgeon for an X-ray and proper diagnosis."

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